Discussing sexual health with cancer patients should start with diagnosis and continue throughout the treatment process, experts say.

Sexual problems, such as erectile dysfunction (ED) and painful intercourse, are common among cancer patients and survivors. But in a recent study published in the Journal of Sexual Medicine, less than half of 200 cancer patients surveyed said they had received information on sexuality from their healthcare providers before starting treatment. Past research suggests that such conversations are more likely to occur after patients finish treatment.

For this study, the participants included 77 men (average age 61 years) and 123 women (average age 53 years) who were scheduled to start radiotherapy at the same French medical center within the next three months. About two-thirds of the respondents had pelvic or breast cancers. For most, it was their first experience with cancer.

The researchers developed a questionnaire to learn more about the patients’ cancer, sexual function, concerns about sex, and need for sexual health care. They also asked about information received from the patients’ healthcare team.

In addition, the participants completed the Sexual Quality of Life Questionnaire, which covered topics such as sexual confidence, emotional well-being, and relationship issues. Higher scores on this assessment indicated a better sexual quality of life.

Eighty percent of the participants said they had been sexually active in the year before their diagnosis; 35% reported having a sexual problem before diagnosis.

However, after diagnosis, 30% of the sexually-active respondents stopped having sex, and 28% had intercourse less frequently.

The men had higher sexual quality of scores than the women did. The authors noted that because the female participants were generally younger than the men (and tended to have younger partners), perhaps sexual issues had a greater impact on the women’s sexual quality of life. They added that men in France “have access to more efficient pharmacological and surgical treatments,” for sexual issues than women do.

Men were also more likely to receive information about sexuality and cancer compared to the women. The authors explained that France had a more established system for treating male sexual problems. They added that about half of the oncologists in France were men. It’s possible that these physicians did not feel comfortable discussing sexual concerns with women.

Just over half the participants said they would take advantage of sexuality care services if their doctor referred them. More respondents said they would prefer medical care over couple therapy, possibly because medical care is reimbursed by the French healthcare system, unlike psychotherapy, the authors said. In addition, there is still a stigma associated with psychosexual care. And men may prefer medical care as drug treatments can only be prescribed by doctors.

“These [study] results suggest that early intervention could improve sexual quality of life and is particularly needed in women, who should benefit, like men, from a system of treating female sexual dysfunction,” the authors concluded.